Syndrome D’aniridie Associé À La Dermatite Atopique: À Propos D’un Cas

Aniridia syndrome is a genetic anomaly affecting all ocular structures; it is transmitted by an autosomal dominant mode. In its isolated form aniridia is characterized by a hypoplasia of the iris frequently associated with other ocular anomalies. It the syndromic form it is associated to other systemic abnormalities. Authors are here reporting a case of aniridia associating: a corneal pannus, total aniridia, lens ectopia, and cataract found in a 14 years old girl. She also presented an atopic background with a positive family history of atopia. She is issued from a first degree consanguineous marriage. The management was multidisciplinary. In ophthalmology she underwent an intra-capsular extraction of the lens in both eyes with no intra-ocular lens implantation. Dermatological management was treatment of cuteanous lesions with emollients, corticoids and antihistamines drugs and ointments

Atteintes Oculaires Au Cours Du Syndrome De Wolfram À Propos De Deux Cas Et Revue De La Littérature

Introduction: Wolfram syndrome is an autosomal recessive neurodegenerative disorder. Diabetes mellitus and juvenile bilateral optic atrophy are its major signs. It is recognized that this association, which started in childhood or during adolescence, is sufficient to diagnose Wolfram syndrome. Optic atrophy occurs in 98% to 100% of cases with an average age of onset of 11 years. We reported a study of two confirmed cases referred by the internal medicine department. Observations: Case 1: A 23- year-old woman, deaf and dumb by birth, went through a diabetic ketosis test. Ophthalmologic examination showed reduced visual acuity in the fingers at 5 meters P2 in both eyes. Also, the fundus of the eye showed bilateral atrophic papillary palpation with no signs of retinopathy. She had deafness of deep perception and hypogonadotropic hypogonadism. Deafness, diabetes, optic atrophy, and hypogonadism led to the diagnosis. Case 2: A 21-year-old man born from a first-degree consanguineous marriage serves as a supplement to the management of diabetes. The visual acuity was at counting fingers at 1m to the right eye and sees the hand move to 0.5 m to the left eye. On examination at the slit lamp, it had a bilateral dense cataract. After phacoexeresis, the base revealed bilateral optic atrophy. Ultrasound of the urinary tree showed hypotonia of the renal cavities and a neurogenic bladder. Also, audiometry showed mild sensory deafness. The diagnosis of Wolfram syndrome was made in front of the tetrad: diabetes, optic atrophy, deafness, and urinary signs. Discussion: Wolfram syndrome may be familial or sporadic. The gene however is located on the short arm of chromosome 4. Optic atrophy is secondary to the involvement of pre-genetic fibers, and it is characterized initially by temporal palpation of the papilla. The evolution towards diffuse whitish discoloration occurs in a few months or years with the gradual establishment of a blindness around the age of 17 to 30 years. Conclusion: Wolfram syndrome is a clinical entity characterized by clinical and genetic polymorphism. This diagnosis should be considered in the presence of any type I diabetes associated with optic atrophy in childre

Orbital Myositis with Sudden Visual Loss: A Case Study in Niamey, Niger

This paper focuses on presenting a case study of three cases of orbital myositis in one male and two female adult patients. All patients presented sudden loss of vision and proptosis at the initial stage. Ophthalmological examination outlined optic nerve atrophie. The diagnosis of all cases was confirmed with a CT scan which showed specific muscle inflammation. The treatment was successfully carried out using bolus doses of corticosteroids relayed with oral prednisolone for over 6 weeks. Six (6) months follow-up, however, did not show any relapse in all the cases

Volumineux Mélanome Malin De La Conjonctive Multi Récidivant À Propos d’un Cas

Melanoma of the conjunctiva is a tumor that develops from the conjunctival melenocytes. It often reoccurs even after several surgical removals. The authors present the case of a 45 years old woman who was at first seen in our outpatient clinic with a spitz naevus of the conjunctiva of the right eye since more than 20 years ago. This naevus which was excised twice and then the eye enucleated underwent malignant transformation into a voluminous multi-recidivant malignant melanoma weighing after surgical removal 350g and measures 6x12x5cm

Les particularités du rétinoblastome au Niger

Aims: To describe the clinical peculiarities of retinoblastoma and to outline the difficulties in their management in our context. Patients and Methods: We carried out a prospective study in all the cases of retinoblastoma from January 2014 to July 2015 in Niamey National Hospital. We studied: age, sex, first sign, age at first symptoms, time taken to seek medical help, anterior treatment , consanguinity, laterality, stage of tumor, extension of tumor, treatment done, survival rate. Results: The study was about 57 kids, among which 38 boys and 19 girls giving a sex ratio of 2.The mean age at diagnosis was 32 months with extremes of 7 months and 6 years. The range 2 to 3 years were most affected with 35 cases (61, 4%). Leucocorie was the onset symptom in 50 cases (87, 7%), strabismus in 7 cases (12, 3%). Traditional treatment was seen in 45 patients (79%). Consanguinity was found in 45 cases (79%), no family history of tumor was found in this study. In 38 cases (66, 66%) diagnosis was after one year of onset, the left eye was affected in 22 patients (38, 59%), the right eye in 21 patients (36, 84%) and it was bilateral in 14 cases (24, 56%). All our patients were at stage V of Reese classification, the tumor was extra-ocular in 54 patients (94, 6%) and intra-ocular in 5, 4% of cases. Enucleation was performed in 46 cases (80, 70%) and 56 patients (94, 73%) underwent chemotherapy cure. The survival rate after 18 months was of 15, 78%. Conclusion: Late presentation, diagnosis at an advance stage, and limited treatment options are the main factors responsible for the low rate of survival in this study

Anthropometric indices of Gambian children after one or three annual rounds of mass drug administration with azithromycin for trachoma control.

BACKGROUND: Mass drug administration (MDA) with azithromycin, carried out for the control of blinding trachoma, has been linked to reduced mortality in children. While the mechanism behind this reduction is unclear, it may be due, in part, to improved nutritional status via a potential reduction in the community burden of infectious disease. To determine whether MDA with azithromycin improves anthropometric indices at the community level, we measured the heights and weights of children aged 1 to 4 years in communities where one (single MDA arm) or three annual rounds (annual MDA arm) of azithromycin had been distributed. METHODS: Data collection took place three years after treatment in the single MDA arm and one year after the final round of treatment in the annual MDA arm. Mean height-for-age, weight-for-age and weight-for-height z scores were compared between treatment arms. RESULTS: No significant differences in mean height-for-age, weight-for-age or weight-for-height z scores were found between the annual MDA and single MDA arms, nor was there a significant reduction in prevalence of stunting, wasting or underweight between arms. CONCLUSIONS: Our data do not provide evidence that community MDA with azithromycin improved anthropometric outcomes of children in The Gambia. This may suggest reductions in mortality associated with azithromycin MDA are due to a mechanism other than improved nutritional status

Elimination of Active Trachoma after Two Topical Mass Treatments with Azithromycin 1.5% Eye Drops

Trachoma is the leading cause of infectious blindness worldwide, accounting for 1.3 million cases of blindness. Although it has disappeared in many regions of the world, trachoma is still endemic in Africa, Eastern Mediterranean, Latin America, Asia, and Australia. The WHO has currently set a target of 2020 for controlling trachoma to a low enough level that resulting blindness will not be a major public health concern. Topical tetracycline was for a long time the recommended treatment for active trachoma, but compliance to the regimen is extremely poor. Azithromycin has properties that make it an ideal treatment for Chlamydia trachomatis: high efficacy, intracellular accumulation, and a long tissue half-life. There is now a new mass treatment of trachoma by azithromycin 1.5% eye drops which is as effective as the oral route. In the test health district of Kolofata, Cameroon, the prevalence of trachoma among children dramatically decreased from 31% to less than 5% after 2 treatments. A third treatment was performed in January 2010. An epidemiological surveillance is implemented to see if this removal will be permanent. It also avoids misuse of oral azithromycin and the eye drops are directly treating the site of the infection

Specification and Implementation of Dynamic Web Site Benchmarks

The absence of benchmarks for Web sites with dynamic content has been a major impediment to research in this area. We describe three benchmarks for evaluating the performance of Web sites with dynamic content. The benchmarks model three common types of dynamic content Web sites with widely varying application characteristics: an online bookstore, an auction site, and a bulletin board. For the online bookstore, we use the TPCW specification. For the auction site and the bulletin board, we provide our own specification, modeled after ebay.com and slahdot.org, respectively. For each benchmark we describe the design of the database and the interactions provided by the Web server. We have implemented these three benchmarks with a variety of methods for building dynamic-content applications, including PHP, Java servlets and EJB (Enterprise Java Beans). In all cases, we use commonly used open-source software. We also provide a client emulator that allows a dynamic content Web server to be driven with various workloads. Our implementations are available freely from our Web site for other researchers to use. These benchmarks can be used for research in dynamic Web and application server design. In this paper, we provide one example of such possible use, namely discovering the bottlenecks for applications in a particular server configuration. Other possible uses include studies of clustering and caching for dynamic content, comparison of different application implementation methods, and studying the effect of different workload characteristics on the performance of servers. With these benchmarks we hope to provide a common reference point for studies in these areas

[Accepted Manuscript] Anthropometry and Malaria among Children in Niger: A Cross-Sectional Study.

The complex relationship between malnutrition and malaria affects morbidity and mortality in children younger than 5 years, particularly in parts of sub-Saharan Africa where these conditions occur together seasonally. Previous research on this relationship has been inconclusive. Here, we examine the association between anthropometric indicators and malaria infection in a population-based sample of children younger than 5 years in Niger. This cross-sectional study is a secondary analysis of a cluster-randomized trial comparing treatment strategies for trachoma in Niger. We included children aged 6-60 months residing in the 48 communities enrolled in the trial who completed anthropometric and malaria infection assessments at the final study visit. We evaluated the association between anthropometric indicators, including height-for-age z-score (HAZ) and weight-for-age z-score (WAZ) and indicators of malaria infection, including malaria parasitemia and clinical malaria. In May 2013, we collected data from 1,649 children. Of these, 780 (47.3%) were positive for malaria parasitemia and 401 (24.3%) had clinical malaria. In models of malaria parasitemia, the adjusted odds ratio (aOR) was 1.05 (95% confidence interval [CI]: 1.00-1.10) for HAZ and 1.07 (95% CI: 0.99, 1.15) for WAZ. In models of clinical malaria, the aOR was 1.07 (95% CI: 1.02-1.11) for HAZ and 1.09 (95% CI: 1.01-1.19) for WAZ. Overall, we did not find evidence of an association between most anthropometric indicators and malaria infection. Greater height may be associated with an increased risk of clinical malaria

Impact of mass azithromycin distribution on malaria parasitemia during the low-transmission season in Niger: a cluster-randomized trial.

We assessed the effect of mass azithromycin treatment on malaria parasitemia in a trachoma trial in Niger. Twenty-four study communities received treatment during the wet, high-transmission season. Twelve of the 24 communities were randomized to receive an additional treatment during the dry, low-transmission season. Outcome measurements were conducted at the community-level in children < 1-72 months of age in May-June 2011. Parasitemia was higher in the 12 once-treated communities (29.8%, 95% confidence interval [CI] = 21.5-40.0%) than in the 12 twice-treated communities (19.5%, 95% CI = 13.0-26.5%, P = 0.03). Parasite density was higher in once-treated communities (354 parasites/μL, 95% CI = 117-528 parasites/μL) than in twice-treated communities (74 parasites/μL, 95% CI = 41-202 parasites/μL, P = 0.03). Mass distribution of azithromycin reduced malaria parasitemia 4-5 months after the intervention. The results suggest that drugs with antimalaria activity can have long-lasting impacts on malaria during periods of low transmission